The association between psychotic symptoms and suicidal ideation in a sample of patients with schizophrenia: The moderating effect of the frequency of suicidal thoughts

Introduction: Suicidal ideation among patients with schizophrenia is ubiquitous and may lead to premature death. The ideation is a significant determinant of attempting and committing suicide. Aim: This study aims to examine the moderating role of the frequency of suicidal thoughts on the relationship between psychotic symptoms and suicidal ideation in a sample of Jordanian patients with schizophrenia. Materials and methods: This cross-sectional study used a non-experimental moderation design to recruit participants using convenience sampling. A total of 204 patients with schizophrenia completed self-administered questionnaires. Results: The significant predictors of suicidal ideation were sex, whether or not the individual adhered to their medication prescription, age, the number of previous suicidal thoughts an individual had, and negative symptoms. For all suicidal ideation subscales except subscale 3 (suicide contemplation), positive psychotic symptoms were a significant predictor of suicidal ideation. The frequency of suicidal thoughts reduced (moderated) the effect of negative symptoms on suicidal ideation while amplifying the effect of positive psychotic symptoms on all suicidal ideation subscales except subscale 3 (suicide contemplation). Conclusions: This study's results highlight the necessity of reducing suicidal thoughts to diminish the effect that positive psychotic symptoms have on suicidal ideation in patients with schizophrenia. Further research might explore the intricate relationship between psychotic symptoms and the mechanisms included in their complex link to suicidal ideation. Implications for the practice: The results will help psychiatric nurses develop timely and accurate preventive strategies to fight suicidal ideation, assist in identifying which subgroups of patients with schizophrenia are vulnerable to suicidal ideation, and potentially lessen the suicide rate.